A Review of Pediatric Celiac Patients in Southeastern Turkey: A Single-Center Experience

Abstract

Objective: Celiac disease is an autoimmune enteropathy that primarily affects the small intestine. Celiac disease occurs with the ingestion of foods containing gluten and is characterized by malabsorption in individuals with a genetic predisposition. This study aimed to review the clinical, laboratory, radiological, and pathological findings of pediatric celiac patients who were followed in our clinic and to compare the data with previous reports in the literature. Methods: A total of 509 patients who were diagnosed with celiac disease in the Pediatric Gastroenterology Clinic between 2010 and 2013 were included in this study. Medical records of the patients were reviewed retrospectively to collect their demo-graphic characteristics, anthropometric and bone mineral density measurements, laboratory results, radiological imaging, endoscopic examinations, and pathology reports of the biopsy materials. Results: Of the 509 patients enrolled in the study, 290 (57%) were females and 219 (43%) males. Among these patients, 441 (86.6%) presented with typical symptoms and 68 (13.4%) presented with atypical symptoms. A total of 479 (94.1%) patients were compliant with the gluten-free diet, whereas 30 (5.9%) patients were not. The chief complaint was growth retardation in the patient groups aged 61 to 144 months (44.6%) and >145 months (59%) and diarrhea (26.1%) in the patient group aged 0-60 months. In all patients, the most common physical examination findings at the time of presentation were normal (57.4%), and the most common comorbidities were iron deficiency anemia (35%) and osteoporosis (33%). While Marsh-Oberhuber stage 3c (52.5%) was most common in patients aged 0-60 months, Marsh-Oberhuber stage 3b was most common in patients aged 61-144 months and patients aged >145 months (51.9% and 63.8%, respectively). Conclusions: Although growth and developmental retardation and chronic diarrhea are cautionary for celiac disease, patients may also present with extra-gastrointestinal (atypical) findings. The mainstay of celiac disease treatment is strict compliance with a gluten-free diet. Reviewing a relatively large number of cases, this study sheds some light on the current status of pedi-atric celiac disease patients in the southeastern part of Turkey. Keywords: Celiac disease, child, Marsh